Giving More Voice To Future Health Care Planning

Many more people in Otago and Southland can now rest
assured health providers will know what their health care
wishes are at times where they are unable to speak for
themselves, often at the end of their lives.

In
February 2024, WellSouth, the primary health organisation
(PHO) for Otago and Southland, changed the way they fund
general practices to support patients writing and recording
Advance Care Plans (ACP).

WellSouth has
created a funding stream for practices to claim for
processing ACPs, alongside offering training and support via
two dedicated WellSouth Shared Care Plan
Coordinators.

The funding from WellSouth for general
practices means that anyone 60 years and over, or people of
any age who are Māori, Pasifika or who are former refugees
are eligible for a free ACP consultation. General practices
can identify these people and contact them to start talking
about advance care planning.

Since ACP consultations
became funded by WellSouth in February 2024, 36 general
practices have created 154 ACPs, well above previous
years.

WellSouth Shared Care Plan Coordinator, Helen
Sawyer, says, “Creating an ACP involves thinking and
talking about your values and goals and what your
preferences are for your current and future health
care.”

People can write what is important to them in
a book available from their general practice. Alternatively,
there is an ACP template on the national advance care
planning website which can be downloaded at www.myacp.org.nz.
People can start their ACP with or without help from a
health professional. Most people work with the team at their
general practice, however health professionals in hospitals
and aged care facilities and other health providers can also
help.

Mrs Sawyer says these conversations are critical
to people and their families.

“An advance care plan
speaks for you often because you can no longer speak for
yourself,” she explains.

“However, while these
plans are important, clinicians often have limited time, and
feedback to WellSouth from practices was that ACPs, done
well, take time to complete and upload. The funding for ACPs
is in recognition of this feedback, acknowledging the time
and effort to complete these plans with patients,” says
Mrs Sawyer.

People can discuss their
wishes with a GP, practice nurse, Health Improvement
Practitioner or Health Coach at their general practice. To
ensure plans reflect the person’s wishes needs and are
clinically safe, all plans are signed off by a GP or nurse
at the practice the patient is enrolled
at.

Mrs Sawyer or Michelle Anderson, also
a WellSouth Shared Care Plan Coordinator, review the ACPs to
ensure they are medically interpretable across the spectrum
of healthcare provision. This process also ensures that the
person’s voice is heard during critical health events. The
Shared Care Plan Coordinators also support practices with
advice particularly on complex plans, and in rare instances
do home visits, when people are unable to visit their
general practice, for example.

“The funding
availability is helping people, and their loved ones access
the support required to complete an ACP, and feel secure in
their wishes being met, easing anxieties and burdens,”
says Mrs Sawyer.

“These plans are important to a
person and their family. They should be in a person’s life
kit with wills and insurance policies, and we encourage
anyone to have an ACP conversation with those they love, and
to contact your general practice to ask for an
appointment.”

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